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Practice Partner: Look Ma, No Wires! by Lori Upshur Emerald Communications and Training Committee In many of MUSC's ambulatory clinics, doctors and nurses use a software program called Practice Partner or PMSI (Physician Micro Systems Inc). Practice Partner is an integral part of MUSC's Electronic Medical Records project (Emerald), which is intended to eventually replace the paper chart carried into each exam room.  Neurology's Dr. Stephen Haines, right, demonstrates a new, efficient software program called Practice Partner, with 7-month-old patient Austin Hagwood and his mother, Cheray. PMSI was first used on campus in the Family Medicine clinic about nine years ago. It began as a DOS-based application to keep track of patient notes and medicines. PMSI has evolved into a system used not only in Family Medicine but also in the University Diagnostic Center (UDC), Adult Primary Care and many Pediatric clinics.  The UMA Ambulatory Care staff is currently working on setting up PMSI in the OB/GYN clinic, Plastic Surgery Clinic and in the Digestive Disease Clinic (Hepato-Biliary).  The current version of Practice Partner contains patient demographics, visit notes, vital signs, lab results, medicines and even some patient education documentation. One area of the UDC also imports images into the system from a digital camera.  The most recent milestone in the evolution of Practice Partner on campus is taking place in the Neurosurgery clinic. Physicians in that clinic have begun carrying wireless devices called Clios into exam rooms with them. Doctors then access the patient's record directly from the Clio device to review history, vital signs, prescribe medicine and even enter notes. This prototype project is just getting underway but reaction so far is positive.  “We need to move to a medical record and documentation format that is quick, accurate and can follow the patient and doctor through the clinic and hospital, said Neurosurgery Department chairman Steven Haines, M.D. “Making Practice Partner mobile seemed to be the best solution here at MUSC.”  Neurosurgery is using the technology in both its adult and pediatric clinics. There are many benefits to the use of wireless technology. There is a lower cost for the purchase of the systems. MUSC will no longer have to purchase a computer to go in each exam room. Additionally,  licensing PMSI for each workstation is not necessary. The use of the smaller remote devices can be less intimidating for the patients. Because of budget crises that have resulted in the reduced availability of transcription services, all UMA Ambulatory Care clinics are attempting direct entry of notes. Taking this one step further, the Pediatric Primary Care Clinic is currently trying to move to a completely paperless environment. Practice Partner is being used in exam rooms, nursing stations, faculty offices and is being remotely accessed by physicians.  The next big step for Practice Partner will be the conversion of all data from the existing backend database to a new Oracle database. Family Medicine has been running on the Oracle database for some time. The time frame to move all other areas to Oracle is by mid-November. This move will provide more stability and more reporting capabilities as well as opening up other opportunities for scanning forms into PMSI.  In addition to the conversion to Oracle, the UMA Ambulatory Care team is working on several other projects. Amy Alexander, a consultant from Data Managers Inc., is working on a touch screen application that will allow patients to fill out the registration questionnaires on-line. The data will feed straight into PMSI, eliminating additional input by registration staff. Also in development are more direct feeds from other systems. Practice Partner currently receives from Oacis patients’ discharge summaries, op notes, lab results and radiology. Coming soon are microbiology results, pathology, ER notes and consult notes. In time there will be a feed from PMSI to Oacis as well.  As the effort to move to a complete Electronic Medical Record continues, Practice Partner will continue to evolve.  For further information on Practice Partner contact Tasia Walsh by e-mail (walshta@musc.edu).